| NPI | 1043480924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDA JANE ANDERSON Office Manager 918-825-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 4382) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |